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Flor LS, Anderson JA, Ahmad N, Aravkin A, Carr S, Dai X, Gil GF, Hay SI, Malloy MJ, McLaughlin SA, Mullany EC, Murray CJL, O'Connell EM, Okereke C, Sorensen RJD, Whisnant J, Zheng P, Gakidou E. Health effects associated with exposure to secondhand smoke: a Burden of Proof study. Nat Med 2024; 30:149-167. [PMID: 38195750 PMCID: PMC10803272 DOI: 10.1038/s41591-023-02743-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Despite a gradual decline in smoking rates over time, exposure to secondhand smoke (SHS) continues to cause harm to nonsmokers, who are disproportionately children and women living in low- and middle-income countries. We comprehensively reviewed the literature published by July 2022 concerning the adverse impacts of SHS exposure on nine health outcomes. Following, we quantified each exposure-response association accounting for various sources of uncertainty and evaluated the strength of the evidence supporting our analyses using the Burden of Proof Risk Function methodology. We found all nine health outcomes to be associated with SHS exposure. We conservatively estimated that SHS increases the risk of ischemic heart disease, stroke, type 2 diabetes and lung cancer by at least around 8%, 5%, 1% and 1%, respectively, with the evidence supporting these harmful associations rated as weak (two stars). The evidence supporting the harmful associations between SHS and otitis media, asthma, lower respiratory infections, breast cancer and chronic obstructive pulmonary disease was weaker (one star). Despite the weak underlying evidence for these associations, our results reinforce the harmful effects of SHS on health and the need to prioritize advancing efforts to reduce active and passive smoking through a combination of public health policies and education initiatives.
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Affiliation(s)
- Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Jason A Anderson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Noah Ahmad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gabriela F Gil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Matthew J Malloy
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chukwuma Okereke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joanna Whisnant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Luo Y, He P, Wen X, Gong R, Hu X, Zheng X. Otitis Media and Its Association With Hearing Loss in Chinese Adults: A Population Based Study of 4 Provinces in China. Front Public Health 2022; 10:852556. [PMID: 35651868 PMCID: PMC9149286 DOI: 10.3389/fpubh.2022.852556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Otitis media is a recognized cause of significant hearing loss, particularly in developing countries. This study aimed to investigate the relationship between otitis media and hearing loss in Chinese adults aged 18 years and older. Methods The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 36,783 adults at the ages between 18 years and above were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. All participants underwent clinical ENT check-up and otoscopic examination by doctors trained in ENT. Each participant was assigned a single middle ear diagnosis. Diagnoses were assigned as per the WHO classification of ear and hearing disorders. Results Logistic regressions showed that higher prevalence of hearing loss was found in participants with otitis media, with an unadjusted odds ratio of 5.67 (95%CI: 4.66, 6.90). The next two models (Model 2–3) had slight impact on ORs. The interaction of residency and otitis media was statistically significant (OR = 1.70, 95%CI = 1.15, 2.53); otitis media patients in rural areas had higher risk of hearing loss. However, this interaction became not significant in 65 years old and above participants. Conclusions Otitis media was associated with the risk of hearing loss. Compared with urban patients with otitis media, rural patients have the higher risk of hearing loss. Action to reduce the risk of hearing loss in otitis media will require attention to rural-urban disparities.
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Affiliation(s)
- Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xu Wen
- College of Biochemical Engineering, Beijing Union University, Beijing, China
| | - Rui Gong
- China Rehabilitation Research Center for Deaf Children, Beijing, China
| | - Xiangyang Hu
- China Rehabilitation Research Center for Deaf Children, Beijing, China
| | - Xiaoying Zheng
- Chinese Academy of Medical Sciences/Peking Union Medical College, School of Population Medicine and Public Health, Beijing, China
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Pérez-Herrera LC, Peñaranda D, Moreno-López S, Otoya-Tono AM, Gutiérrez- Velasco L, García JM, Peñaranda A. Associated factors, health-related quality of life, and reported costs of chronic otitis media in adults at two otologic referral centers in a middle-income country. PLoS One 2020; 15:e0244797. [PMID: 33382816 PMCID: PMC7775072 DOI: 10.1371/journal.pone.0244797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023] Open
Abstract
Background Despite the high prevalence of chronic otitis media (COM) in low to middle-income countries, there are few studies regarding its associated factors, health-related quality of life, and treatment costs. This study aimed to identify associated factors of COM, assess its impact on the quality of life as well as estimate the patients’ reported costs of COM treatment in Colombia. Methods Cross-sectional study. Two otology-referral centers in Bogotá (Colombia) were included. Questionnaires focusing on sociodemographic and clinical associated factors, quality of life, and patients’ reported costs were administered to 200 adults with COM diagnosis and 144 control adults. Otoscopic evaluation and audiometric data were collected. Results The mean age was 42.2 years (SD: 14.44). The median length of COM was 26.13 years (SD: 17.06), and 79.5% of the COM patients reported otorrhea during childhood (P-value: 0.01). The most frequently reported allergic disease among our study population was allergic rhinitis (26.5%). COM was less frequent in patients with a medium-high socioeconomic status (PR: 0.54; 95% CI: 0.39–0.72), and more frequent in patients who reported increased ear discharge due to upper respiratory tract infections (PR: 1.69; 95% CI: 1.68–1.70). The global score of the “Chronic Suppurative Otitis Media Questionnaire-12” showed a difference of 9 points between patients with active and inactive COM (P < 0.001). Patients spent between 12.07% to 60.37% of their household income on expenses related to COM. Conclusions Associated factors found in this study are consistent with previous reports. COM has a significant financial impact and affects patients’ quality of life. Worldwide research addressing these issues in poor-resource countries is scarce, further studies are needed.
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Affiliation(s)
- Lucia C. Pérez-Herrera
- Otolaryngology and Allergology Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- Faculty of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Daniel Peñaranda
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | - Sergio Moreno-López
- Otolaryngology and Allergology Research Groups, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ-ORL), Bogotá, Colombia
- Faculty of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Ana M. Otoya-Tono
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | | | - Juan Manuel García
- Faculty of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
- Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Augusto Peñaranda
- Faculty of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- * E-mail:
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Coleman A, Wood A, Bialasiewicz S, Ware RS, Marsh RL, Cervin A. The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media. MICROBIOME 2018; 6:199. [PMID: 30396360 PMCID: PMC6219068 DOI: 10.1186/s40168-018-0577-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/15/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Otitis media (OM) imposes a great burden of disease in indigenous populations around the world, despite a variety of treatment and prevention programs. Improved understanding of the pathogenesis of OM in indigenous populations is required to advance treatment and reduce prevalence. We conducted a systematic review of the literature exploring the upper airway and middle ear microbiota in relation to OM in indigenous children. METHODS Papers targeting microbiota in relation to OM in children < 18 years indigenous to Australia, New Zealand, North America, and Greenland were sought. MEDLINE, CINAHL, EMBASE, Cochrane Library, and Informit databases were searched using key words. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA guidelines. RESULTS Twenty-five papers considering indigenous Australian, Alaskan, and Greenlandic children were included. There were high rates of nasopharyngeal colonization with the three main otopathogens (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis) in indigenous children with OM. Middle ear samples had lower rates of otopathogen detection, although detection rates increased when molecular methods were used. Pseudomonas aeruginosa and Staphylococcus aureus were commonly detected in middle ear discharge of children with chronic suppurative OM. There was a significant heterogeneity between studies, particularly in microbiological methods, which were largely limited to culture-based detection of the main otopathogens. CONCLUSIONS There are high rates of otopathogen colonization in indigenous children with OM. Chronic suppurative OM appears to be associated with a different microbial profile. Beyond the main otopathogens, the data are limited. Further research is required to explore the entire upper respiratory tract/middle ear microbiota in relation to OM, with the inclusion of healthy indigenous peers as controls.
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Affiliation(s)
- Andrea Coleman
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland Australia
- Queensland Pediatric Infectious Disease Laboratory, Centre for Children’s Health Research, Children’s Health Queensland Hospital, Queensland University of Technology, Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, Queensland 4101 Australia
| | - Amanda Wood
- The Deadly Ears Program, Children’s Health Queensland Hospital and Health Service, Brisbane, Queensland Australia
| | - Seweryn Bialasiewicz
- Queensland Pediatric Infectious Disease Laboratory, Centre for Children’s Health Research, Children’s Health Queensland Hospital, Queensland University of Technology, Child Health Research Centre, The University of Queensland, 62 Graham Street, South Brisbane, Queensland 4101 Australia
| | - Robert S. Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland Australia
| | - Robyn L. Marsh
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory Australia
| | - Anders Cervin
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland Australia
- Head & Neck Surgery, Department of Otolaryngology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland Australia
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Singleton R, Seeman S, Grinnell M, Bulkow L, Kokesh J, Emmett S, Holve S, McCollum J, Hennessy T. Trends in Otitis Media and Myringotomy With Tube Placement Among American Indian and Alaska Native Children and the US General Population of Children After Introduction of the 13-valent Pneumococcal Conjugate Vaccine. Pediatr Infect Dis J 2018; 37:e6-e12. [PMID: 28746264 DOI: 10.1097/inf.0000000000001704] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND American Indian/Alaska Native (AI/AN) children have experienced higher otitis media (OM) outpatient visit rates than other US children. To understand recent trends, we evaluated AI/AN OM rates before and after 13-valent pneumococcal conjugate vaccine introduction. METHODS We analyzed outpatient visits listing OM as a diagnosis among AI/AN children <5 years of age from the Indian Health Service National Patient Information Reporting System for 2010-2013. OM outpatient visits for the general US child population <5 years of age were analyzed using the National Ambulatory Medical Care and National Hospital Ambulatory Care Surveys for 2010-2011. RESULTS The 2010-2011 OM-associated outpatient visit rate for AI/AN children (63.5 per 100/year) was similar to 2010-2011 rate for same-age children in the general US population (62.8) and decreased from the 2003 to 2005 AI/AN rate (91.4). Further decline in AI/AN OM visit rates was seen for 2010-2011 to 2012-2013 (P < 0.0001). The AI/AN infant OM visit rate (130.5) was 1.6-fold higher than the US infant population. For 2010-2011, the highest AI/AN OM visit rate for <5 year olds was from Alaska (135.0). CONCLUSIONS AI/AN <5-year-old OM visits declined by one third from 2003-2005 to 2010-2011 to a rate similar to the US general population <5 years. However, the AI/AN infant OM rate remained higher than the US infant population. The highest AI/AN <5-year-old OM rate occurred in Alaska.
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Kørvel-Hanquist A, Koch A, Niclasen J, Dammeye J, Lous J, Olsen SF, Homøe P. Risk Factors of Early Otitis Media in the Danish National Birth Cohort. PLoS One 2016; 11:e0166465. [PMID: 27851778 PMCID: PMC5113063 DOI: 10.1371/journal.pone.0166465] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/28/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess risk factors of otitis media (OM) in six-months-old children. METHOD The sample consisted of 69,105 mothers and their children from the Danish National Birth Cohort. The women were interviewed twice during pregnancy and again 6 months after birth. The outcome "one or more" maternal reported episodes of OM at age six months. In total 37 factors were assessed, covering prenatal, maternal, perinatal and postnatal factors. RESULTS At age six months 5.3% (95% CI 5.1-5.5) of the children had experienced one or more episodes of OM. From the regression analysis, 11 variables were associated with a risk of OM. When a Bonferroni correction was introduced, gender, prematurity, parity, maternal age, maternal self-estimated health, taking penicillin during pregnancy, and terminating breastfeeding before age six months, was associated with a risk of early OM. The adjusted ORs of OM for boys versus girls was 1.30 (95% CI 1.18-1.44). The OR having one sibling versus no siblings was 3.0 (95% CI 2.64-3.41). If the woman had been taking penicillin during pregnancy, the OR was 1.35 (95% CI 1.15-1.58). Children born before 38th gestational week had an increased OR for early OM of 1.49 (95% CI 1.21-1.82). Children of young women had an increased OR of early OM compared to children of older women. Additionally, children of women who rated their own health low compared to those rating their health as high, had an increased OR of 1.38 (95% CI 1.10-1.74). Finally, children being breastfeed less than 6 months, had an increased OR of 1.42 (95% CI 1.28-1.58) compared to children being breastfeed beyond 6 months. CONCLUSION These findings indicate that prenatal factors are of less importance regarding early OM before the age of six months. Postnatal risk factors seem to pose the main risk of early OM.
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Affiliation(s)
- Asbjørn Kørvel-Hanquist
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
- * E-mail:
| | - Anders Koch
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen, Denmark
| | - Janni Niclasen
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Center for Collaborative Health, Aarhus University, Aarhus, Denmark
| | - Jesper Dammeye
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jørgen Lous
- Research Unit for General Practice Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sjurdur Frodi Olsen
- Department of Epidemiology Research, Centre for Fetal Programming, Statens Serum Institut, Copenhagen, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
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Ear Infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children. Int J Pediatr 2016; 2016:1523897. [PMID: 26977160 PMCID: PMC4764758 DOI: 10.1155/2016/1523897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 01/12/2016] [Indexed: 12/04/2022] Open
Abstract
Background. Ear infections in children are a major health problem and may be associated with hearing impairment and delayed language development. Objective. To determine the prevalence and the associated risk factors of ear infections in children 6–17 years old residing on two reserves and rural areas in the province of Saskatchewan. Methodology. Data were provided from two rural cross-sectional children studies. Outcome variable of interest was presence/absence of an ear infection. Logistic regression analysis was conducted to examine the relationship between ear infection and the other covariates. Results. The prevalence of ear infection was 57.8% for rural Caucasian children and 43.6% for First Nations children living on-reserve. First Nations children had a lower risk of ear infection. Ear infection prevalence was positively associated with younger age; first born in the family; self-reported physician-diagnosed tonsillitis; self-reported physician-diagnosed asthma; and any respiratory related allergy. Protective effect of breastfeeding longer than three months was observed on the prevalence of ear infection. Conclusions. While ear infection is a prevalent condition of childhood, First Nations children were less likely to have a history of ear infections when compared to their rural Caucasian counterparts.
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Orji FT, Dike BO, Oji O. Determinants of non-healing ear discharge in chronic suppurative otitis media in a developing country. Eur Arch Otorhinolaryngol 2014; 272:2713-8. [DOI: 10.1007/s00405-014-3255-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 08/19/2014] [Indexed: 11/30/2022]
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Adebola SO, Ologe FE, Alabi BS, Nwabuisi C, Fowotade A. Profile of anaerobic bacteriology of middle ear aspirates in a developing country: Does immunocompromise play a role? Anaerobe 2014; 26:31-5. [DOI: 10.1016/j.anaerobe.2014.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 12/17/2013] [Accepted: 01/01/2014] [Indexed: 10/25/2022]
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Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY. Risk factors for chronic and recurrent otitis media-a meta-analysis. PLoS One 2014; 9:e86397. [PMID: 24466073 PMCID: PMC3900534 DOI: 10.1371/journal.pone.0086397] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 12/09/2013] [Indexed: 11/30/2022] Open
Abstract
Risk factors associated with chronic otitis media (COM) and recurrent otitis media (ROM) have been investigated in previous studies. The objective of this study was to integrate the findings and determine the possible risk factors for COM/ROM based on our meta-analysis. A comprehensive search of electronic bibliographic databases (PubMed, Embase, CNKI and Wanfang database) from 1964 to Dec 2012, as well as a manual search of references of articles, was performed. A total of 2971 articles were searched, and 198 full-text articles were assessed for eligibility; 24 studies were eligible for this meta-analysis. Regarding risk factors for COM/ROM, there were two to nine different studies from which the odds ratios (ORs) could be pooled. The presence of allergy or atopy increased the risk of COM/ROM (OR, 1.36; 95% CI, 1.13–1.64; P = 0.001). An upper respiratory tract infection (URTI) significantly increased the risk of COM/ROM (OR, 6.59; 95% CI, 3.13–13.89; P<0.00001). Snoring appeared to be a significant risk factor for COM/ROM (OR, 1.96; 95% CI, 1.78–2.16; P<0.00001). A patient history of acute otitis media (AOM)/ROM increased the risk of COM/ROM (OR, 11.13; 95% CI, 1.06–116.44; P = 0.04). Passive smoke significantly increased the risk of COM/ROM (OR, 1.39; 95% CI, 1.02–1.89 P = 0.04). Low social status appeared to be a risk factor for COM/ROM (OR, 3.82; 95% CI, 1.11–13.15; P = 0.03). Our meta-analysis identified reliable conclusions that allergy/atopy, URTI, snoring, previous history of AOM/ROM, Second-hand smoke and low social status are important risk factors for COM/ROM. Other unidentified risk factors need to be identified in further studies with critical criteria.
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Affiliation(s)
- Yan Zhang
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Min Xu
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
- * E-mail:
| | - Jin Zhang
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Lingxia Zeng
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
| | - Yanfei Wang
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
- Departments of Otolaryngology-HNS and Genetics, and the Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai, Shandong, China
| | - Qing Yin Zheng
- Department of Otorhinolaryngology-HNS, Second Hospital, Xi’an Jiaotong University School of Medicine, Xi’an, China
- Departments of Otolaryngology-HNS and Genetics, and the Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, United States of America
- Transformative Otology and Neuroscience Center, Binzhou Medical University, Yantai, Shandong, China
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Clinical features and outcome of acute otitis media in early infancy. Int J Infect Dis 2013; 17:e317-20. [DOI: 10.1016/j.ijid.2012.11.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 11/05/2012] [Accepted: 11/09/2012] [Indexed: 11/17/2022] Open
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Daly KA, Hoffman HJ, Kvaerner KJ, Kvestad E, Casselbrant ML, Homoe P, Rovers MM. Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media. Int J Pediatr Otorhinolaryngol 2010; 74:231-40. [PMID: 19836843 DOI: 10.1016/j.ijporl.2009.09.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Accepted: 09/03/2009] [Indexed: 11/19/2022]
Abstract
The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.
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Affiliation(s)
- Kathleen A Daly
- Department of Otolaryngology and Division of Epidemiology, University of Minnesota, Minneapolis, MN 55435, USA.
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Abstract
Otitis media (OM) is a common illness in young children. OM has historically been associated with frequent and severe complications. Nowadays it is usually a mild condition that often resolves without treatment. For most children, progression to tympanic membrane perforation and chronic suppurative OM is unusual (low-risk populations); this has led to reevaluation of many interventions that were used routinely in the past. Evidence from a large number of randomized controlled trials can help when discussing treatment options with families. Indigenous children in the United States, Canada, Northern Europe, Australia, and New Zealand experience more OM than other children. In some places, Indigenous children continue to suffer from the most severe forms of the disease. Communities with more than 4% of the children affected by chronic tympanic membrane perforation have a major public health problem (high-risk populations). Higher rates of invasive pneumococcal disease, pneumonia, and chronic suppurative lung disease (including bronchiectasis) are also seen. These children will often benefit from effective treatment of persistent (or recurrent) bacterial infection.
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Trends in otitis media and myringtomy with tube placement among American Indian/Alaska native children and the US general population of children. Pediatr Infect Dis J 2009; 28:102-7. [PMID: 19131901 DOI: 10.1097/inf.0b013e318188d079] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Otitis media (OM) morbidity in American Indian and Alaska Native (AI/AN) children is historically higher than that in other US children. METHODS Outpatient visits and hospitalizations listing OM as a diagnosis and outpatient visits listing myringotomy with insertion of tubes as a procedure among AI/AN children <5 years of age from the Indian Health Service National Patient Information Reporting system for 2003-2005 were analyzed. Outpatient visits and hospitalizations with OM for the general US child population were analyzed using the National Hospital Ambulatory Medical Care and National Ambulatory Medical Care Surveys for 2003-2005, and the 2003 Kids' Inpatient Database, respectively. RESULTS The OM-associated outpatient visit rate for AI/AN children <5 years of age (89 per 100 children/yr) for 2003-2005 was less than that reported for 1994-1996 (138); however, the rate increased for Alaska region (158 to 181). The OM outpatient visit and myringotomy with insertion of tubes rates (181 and 2.6 per 100 children/yr, respectively) for AI/AN children in Alaska were higher than rates for children in each of the other IHS regions and rates for US children (63 and 1.8 per 100 children/yr, respectively). The OM outpatient visit rates for AI/AN infants (184), especially in the Alaska region (334), were higher than the rate for US infants (84). CONCLUSIONS The OM-associated outpatient visit rate in AI/AN children <5 years of age has decreased but remains higher than that of the US general child population; however, the rate increased in the Alaska region, where a limited decline in invasive pneumococcal disease has been demonstrated. The ongoing disparity in OM outpatient visit rates among AI/AN children, especially Alaska Native children, indicates a need for new prevention measures, including expanded-valency pneumococcal conjugate vaccines, to reduce OM morbidity.
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Jacoby PA, Coates HL, Arumugaswamy A, Elsbury D, Stokes A, Monck R, Finucane JM, Weeks SA, Lehmann D. The effect of passive smoking on the risk of otitis media in Aboriginal and non-Aboriginal children in the Kalgoorlie-Boulder region of Western Australia. Med J Aust 2008; 188:599-603. [PMID: 18484936 DOI: 10.5694/j.1326-5377.2008.tb01801.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Accepted: 11/12/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the risk of otitis media (OM) associated with passive smoking in young children, and any competing effect between passive smoking and childcare attendance. DESIGN, PARTICIPANTS AND SETTING Prospective cohort study of 100 Aboriginal and 180 non-Aboriginal children born in Kalgoorlie Regional Hospital between 1 April 1999 and 31 January 2003. These children underwent routine clinical examinations by an ear, nose and throat specialist up to three times before the age of 2 years, and tympanometry at routine field follow-up visits from the age of 4 months. Childrens' mothers were interviewed at 1-3 weeks postpartum to provide sociodemographic data. MAIN OUTCOME MEASURES Associations between OM and exposure to environmental tobacco smoke (ETS) and childcare attendance. RESULTS 82 Aboriginal and 157 non-Aboriginal children attended for routine clinical examinations. OM was diagnosed at least once in 74% of Aboriginal children and 45% of non-Aboriginal children; 64% of Aboriginal children and 40% of non-Aboriginal children were exposed to ETS. Exposure to ETS increased the risk of specialist-diagnosed OM in Aboriginal children (OR, 3.54; 95% CI, 1.68-7.47); few attended childcare. Non-Aboriginal children exposed to ETS but not attending childcare were at increased risk of OM (OR, 1.91; 95% CI, 1.07-3.42) while those attending childcare had no increased smoking-related risk. Tympanometry was performed on 87 Aboriginal and 168 non-Aboriginal children; a type B tympanogram (suggesting fluid in the middle ear) was also associated with passive smoking in Aboriginal children. CONCLUSIONS Reducing the exposure of children to ETS is a public health priority, especially for the Aboriginal population. A smoke-free environment will help reduce the burden of OM.
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Affiliation(s)
- Peter A Jacoby
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
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Rhodes KL, Hellerstedt WL, Davey CS, Pirie PL, Daly KA. American Indian breastfeeding attitudes and practices in Minnesota. Matern Child Health J 2008; 12 Suppl 1:46-54. [PMID: 18266094 DOI: 10.1007/s10995-008-0310-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Accepted: 01/11/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We examined the breastfeeding attitudes and practices in an American Indian population in Minnesota. METHODS We interviewed women prenatally (n = 380), at 2-weeks (n = 342) and at 6-months postpartum (n = 256). We conducted multivariable analyses to examine the demographic, behavioral, and attitudinal correlates of breastfeeding initiation and duration. RESULTS Factors positively associated with breastfeeding initiation included positive breastfeeding attitudes and social support for breastfeeding from the woman's husband/boyfriend and her mother. Factors positively associated with breastfeeding at 2-weeks postpartum were support from the woman's mother and positive attitudes about breastfeeding. The prenatal use of traditional American Indian medicines and cigarette smoking were both significantly associated with breastfeeding at 6-months postpartum. CONCLUSIONS Programs to encourage breastfeeding in American Indian communities may be strengthened with protocols to encourage social support, recognition of the perceived health, developmental, and practical benefits of breastfeeding, and a focus on traditional American Indian health practices.
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Affiliation(s)
- Kristine L Rhodes
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
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Early onset otitis media: risk factors and effects on the outcome of chronic suppurative otitis media. Eur Arch Otorhinolaryngol 2007; 265:765-8. [PMID: 18046567 DOI: 10.1007/s00405-007-0544-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Accepted: 11/14/2007] [Indexed: 10/22/2022]
Abstract
The onset of early otitis media (EOM), in the first few months of life has been reported to predict later chronic otitis media (CSOM), although the prevalence rates are increasing little is known about specific risk factors. In this survey we examined the hypothesis that higher risk factors is associated with the development of OM within 1 year compared to later onset and early onset otitis media (OM) has potential for negative outcome of CSOM. This is a survey of the age at onset of otorrhoea and associated risk factors in children with CSOM, in five sites spread in two sub-urban cities in two states in Nigeria. Questionnaires were administered on the informants followed by examination of the children. EOM was seen in 136/189 (70%) with CSOM, the age range was 1-150 months, mean of 59.25 (SD = 44.55). Of the 85 CSOM subjects with hearing loss, EOM accounted for 49 (57.7%) while 36 (42.4%) was later onset, On multivariate analysis (OR = 0.276, CI = 0.133-0.572, P = 0.001) revealing EOM was significant in the development of hearing loss however there was no correlation with the frequency of attack of otorrhoea (OR = 1.025, CI = 0.88-1.19, P = 0.75). Low socioeconomic status seen in 110/136 EOM (P = 0.000), allergy (P = 0.030) and number of people >10 in household (OR = 4.13, CI = 1.81-9.39, P = 0.001) constituted the significant risk for EOM compared to later onset. Bottlefeeding, adenoiditis/adenoid hypertrophy, indoor cooking and upper respiratory infection were not found to have statistical significance in early onset OM compared to later onset OM. This study found correlation between EOM and hearing loss and identified allergy, low social status and chronic exposure to overcrowding through increased number of children in the household significant risk factors for future research focus. This may help in controlling the prevalence of hearing loss accompanying CSOM.
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Lasisi AO, Olaniyan FA, Muibi SA, Azeez IA, Abdulwasiu KG, Lasisi TJ, Imam ZO, Yekinni TO, Olayemi O. Clinical and demographic risk factors associated with chronic suppurative otitis media. Int J Pediatr Otorhinolaryngol 2007; 71:1549-54. [PMID: 17643499 DOI: 10.1016/j.ijporl.2007.06.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2007] [Revised: 05/30/2007] [Accepted: 06/02/2007] [Indexed: 11/21/2022]
Abstract
BACKGROUND The incidence of chronic suppurative otitis media (CSOM) is high worldwide but increasing occurrence of complications appear peculiar to West Africa. However, knowledge of associated risk factors is sparse, we report the sociodemographic risk factors of CSOM with the aim of control of the disease and complications; and possible preventive strategies. METHOD This is a survey of children with CSOM in five sites spread in two suburban cities in two states in Nigeria. Questionnaire was administered on the informants followed by examination of the children. RESULT Of the 189 children, 114 (60%) had developed ear suppuration before 6 months of age, the number of attacks within the previous 18 months ranged between 2-12 with average of 7. Sociodemographic risk factors included low socioeconomic class in 153 (81%), 136 (72%) live in congested houses with more than 10 people and 79 (42%) belonged to families with more than 5 children. Indoor-cooking and infant daycare attendance were 117 (62%) while supine bottlefeeding was 115 (61%) and 34 (18%) of subjects had smoking father. The clinical risk factors were upper respiratory tract infection (URI) 85 (45%), allergy 53 (28%), adenoid 54 (28%) and malnutrition 65 (34%). The univariate analysis revealed that low social class (OR=7.33, CI=4.18-12.83, P=0.0001), malnutrition (OR=3.57, CI=1.88-6.76, P=0.00001), bottlefeeding (OR=2.93, CI=1.63-5.28, P=0.0001), indoor-cooking (OR=1.35, CI=0.88-2.10, P=0.161) and high number of people in a household (OR=0.59, CI=0.34-0.98, P=0.04) are significant in development of OM; while multivariate logistic regression analysis showed malnutrition (OR=3.48, CI=1.633-7.425, P=0.001), low social status (OR=7.74, CI=4.15-14.43, P=0.0001) and indoor-cooking (OR=2.34, CI=1.18-4.66, P=0.014), second table. Parental smoking, daycare attendance, allergy, adenoiditis/adenoidal hypertrophy and upper respiratory tract infection were not found significant. CONCLUSION Low socioeconomic class, malnutrition, congestion from high number of children in the household and bottlefeeding constitute significant risk factor. The early onset of disease (<6 months) may suggest a prenatal predisposition. We need further research for the understanding of the biologic effect of these factors while this remains a database for prevention and control of disease.
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Affiliation(s)
- Akeem O Lasisi
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
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